AB1572 IMPACT OF MATERNAL CONNECTIVE TISSUE DISEASE ON FUNCTIONAL AND STRUCTURAL ABNORMALITIES OF THE HEART IN THE OFFSPRING
Authors: T. Frellesen Neumann, S. S. Andersen, S. Dannesbo, A. S. Sillesen, R. O. Vøgg, K. Schreiber, K. Iversen, H. Bundgaard, A. Axelsson Raja
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Some maternal systemic connective tissue diseases (CTD) and their associated antibodies are linked with adverse fetal outcomes, including increased risk of congenital heart diseases (CHD)<sup>[1,2]</sup>. Whether this increased risk also applies to less severe structural or functional cardiac abnormalities in the fetus is currently unknown. <h3>Objectives</h3> Based on a large cohort of newborns born to mothers with CTD, we aim to assess the association between maternal CTD and structural or functional cardiac abnormalities in the offspring. Data used in the study will be a combination of data collected in the Copenhagen Baby Heart Study (CBHS) and data collected via medical chart review to validate the CTD diagnosis and to obtain information about disease severity, treatment, etc. <h3>Methods</h3> In the CBHS we included more than 25,000 newborns between April 2016 and October 2018. All participants underwent systematic transthoracic echocardiography (TTE) within the first 60 days after birth<sup>[3,4]</sup>. The present study will include newborns from the CBHS born to mothers diagnosed with CTD, as identified through the Danish national health registries. Assuming an overall incidence of CTDs at 2% we expect to include approximately 500 newborns to mothers with CTD. Newborns born to mothers diagnosed with CTD will be matched 1:1 to newborns not exposed to maternal CTD, based on child sex; gestational age at birth; age and weight at time of TTE; and maternal age at delivery. Maternal medical charts will be reviewed to validate the CTD diagnosis and obtain information about disease severity, treatment, etc. The primary endpoint is a composite of functional and structural abnormalities in the heart of the newborns, assessed by echocardiography, including left ventricular structural and functional abnormalities, septum defects, and valve anomalies. <h3>Results</h3> Preliminary results are expected in spring 2023. <h3>Conclusion</h3> It is unclear whether children of mothers with CTD should have routine cardiac evaluation at birth, and whether certain types of maternal CTD have a higher risk of minor/subclinical CHD or less severe cardiac abnormalities in the offspring compared with children born to mothers without CTD. The size of CBHS and the comprehensive assessment of the included children provide a unique opportunity for obtaining new knowledge in this field, including better insights into whether routine TTE after birth should be considered in certain subgroups. <h3>References</h3> [1]Mecacci, F.; Pieralli, A.; Bianchi, B.; Paidas, M. J. The Impact of Autoimmune Disorders and Adverse Pregnancy Outcome. <i>Seminars in Perinatology</i><b>2007</b>, <i>31</i> (4), 223–226. https://doi.org/10.1053/j.semperi.2007.05.005. [2]Liu, S.; Joseph, K. S.; Lisonkova, S.; Rouleau, J.; Van den Hof, M.; Sauve, R.; Kramer, M. S. Association Between Maternal Chronic Conditions and Congenital Heart Defects: A Population-Based Cohort Study. <i>Circulation</i><b>2013</b>, <i>128</i> (6), 583–589. https://doi.org/10.1161/CIRCULATIONAHA.112.001054. [3]Sillesen, A.-S.; Raja, A. A.; Pihl, C.; Vøgg, R. O. B.; Hedegaard, M.; Emmersen, P.; Sundberg, K.; Tabor, A.; Vedel, C.; Zingenberg, H.; Kruse, C.; Wilken-Jensen, C.; Nielsen, T. H.; Jørgensen, F. S.; Jeppesen, D. L.; Søndergaard, L.; Kamstrup, P. R.; Nordestgaard, B. G.; Frikke-Schmidt, R.; Vejlstrup, N.; Boyd, H. A.; Bundgaard, H.; Iversen, K. Copenhagen Baby Heart Study: A Population Study of Newborns with Prenatal Inclusion. <i>Eur J Epidemiol</i><b>2019</b>, <i>34</i> (1), 79–90. https://doi.org/10.1007/s10654-018-0448-y. [4]Vøgg, R. O. B.; Basit, S.; Raja, A. A.; Sillesen, A.-S.; Pihl, C.; Vejlstrup, N.; Jonsen, E. H.; Larsen, O. W.; Zingenberg, H.; Boyd, H. A.; Iversen, K. K.; Bundgaard, H. Cohort Profile: The Copenhagen Baby Heart Study (CBHS). <i>International Journal of Epidemiology</i><b>2022</b>, <i>50</i> (6), 1778–1779m. https://doi.org/10.1093/ije/dyab147. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.